Borderline Personality Disorder

What is borderline personality disorder?

Borderline personality disorder is a condition characterized by long-term mood instability that can disrupt relationships and lead to frequent changes in goals, values and self-identity. People who have borderline personality disorder have a tendency to see things as all bad or all good, and their views about specific people and conditions can fluctuate from one extreme to the other. Suicide attempts and self-injury without suicidal intent are both common.

Coexisting psychiatric conditions, such as depression, anxiety disorders, other personality disorders, or drug and alcohol abuse, may be present. Features of borderline personality disorder appear in other psychiatric conditions, such as mood disorders, post-traumatic stress disorder, and dissociative identify disorder.

Although the cause of borderline personality disorder is not known, it seems to be more common in those whose childhood or adolescence involved abandonment, neglect, separation, disruption, physical or sexual abuse, or poor communication within their families. Borderline personality disorder accounts for 20% of psychiatric hospitalizations, and it is more common in women. It is estimated that about 2% of adults are affected by this disorder (Source: NIMH).

People who have borderline personality disorder often fear abandonment. They may be sensitive to rejection and may meet even minor disappointments with anger. They may respond to perceived abandonment by threatening suicide or self-harm. Relationships may start with intense attachments and admiration, only to end abruptly with profound animosity and devaluation. Impulsive spending and sexual activity, bingeing, and drug use may occur.

The foundation of treatment for borderline personality disorder is psychotherapy, which is often at least partially effective. It may initially focus on self-destructive behaviors, and may start in the hospital if suicide is a concern. Longer-term therapy may include discussion of current and past issues, working on coping skills, and changing thoughts and behaviors. Medications can be helpful and may include mood stabilizers, antidepressants, or antipsychotics, depending on the person’s symptoms.

Self-harm and suicidal behavior, threats, and dangerous actions are common in people who have borderline personality disorder. Seek immediate medical care (call 911) for behavior or actions that could be dangerous, including threatening, irrational or suicidal behavior.

Seek prompt medical care if you are concerned about possible borderline personality disorder or if you are being treated for borderline personality disorder but symptoms recur or are persistent.

Common symptoms of borderline personality disorder

What causes borderline personality disorder?

The cause of borderline personality disorder is not known. Biologic and environmental factors have been identified. It is more common in people whose childhood or adolescence involved abandonment, neglect, separation, disruption, physical or sexual abuse, or poor communications within their families.

What are the risk factors for borderline personality disorder?

How is borderline personality disorder treated?

Psychotherapy forms the foundation of treatment of borderline personality disorder. Medications may be used to treat mood instability, depression, or disordered thinking. Although borderline personality disorder can be difficult to treat, many people improve with therapy. A type of psychotherapy designed specifically for the treatment of borderline personality disorder, called dialectical behav...
Read more about borderline personality disordertreatments